Scientists know that Black people are at a greater risk for health problems like heart disease, diabetes and Alzheimer’s disease than white people. A growing body of research shows that racism in health care and in daily life contributes to these long-standing health disparities for Black communities.
Now, some researchers are asking whether part of the explanation involves how racism, across individual interactions and systems, may physically alter the brain.
“That could be behaviors like, let’s say, a woman clutching her purse as a black man is walking next to her. Or they could be verbal, like someone saying, like… ‘I didn’t expect you to be so articulate,'” says Negar Fani, a clinical neuroscientist at Emory University who studies people experiencing Posttraumatic Stress Disorder, or PTSD.
Recently, Fani has collaborated with Nate Harnett, an assistant professor of psychiatry at Harvard Medical School, to study how the brain responds to traumatic events and extreme stress, including the events and stress related to racism.
Individual insights to systemic issues
So how does one go about measuring the impact of zoomed out, societal-scale issues on the individual?
Harnett is the first to admit, it’s not the simplest task.
“It’s very difficult for neuroimaging to look specifically at redlining,” notes Harnett.
But he can—indirectly.
For example, Harnett has used inequities in neighborhood resources as a way of tracking or measuring structural racism.
“We’re able to look at these sort of proxy measures in these outcomes of structural racism and then correlate those with both brain and behavioral responses to stress or trauma and see how they tie with different psychiatric disorders like PTSD,” Harnett says.
In other research, Harnett and Fani have looked at correlations between racial discrimination and the response to threat in Black women who had experienced trauma. Fani says patients who experience PTSD tend to be more vigilant or show hyperarousal and be startled easily. Fani says their bodies are in a constant state of fight or flight—even when they’re in a safe situation.
But in patients who’ve also experienced racial discrimination, Fani says she sees the opposite effect: They show an increased activation in areas related to emotion regulation.
In some ways, Fani says this activation can be adaptive. For example, people may experience microaggressions or discrimination at work and need to regulate their emotional response in order to get through the moment. Victims of work discrimination may need advice on how to overcome toxic work relations. But when people have to utilize this strategy over long periods of time, Fani and Harnett think it may contribute to the degradation they’ve seen in other areas in the brain.
“There’s no such thing as a free lunch when it comes to the brain,” Harnett says. “Energy has to come from somewhere. And what we think ends up happening is, you know, energy that’s reserved for other processes then gets taken away.”
Harnett says some people have called this process “weathering,” where the stress related to repeated exposure to traumatic experiences erodes parts of the brain.
“Over time, that might contribute to other downstream health problems like cardiovascular disease or diabetes,” he says.
Societal challenges reflected in publishing
Fani and Harnett say they’ve faced challenges in publishing their research that seem to reflect the resistance in the medical field to acknowledging health disparities for minority communities.
Fani says that as part of her research, she’s administered trauma inventories, which ask patients to recount instances of physical or emotional harm, for decades. When she’s used these inventories in papers, they “were never criticized for what they were.” But when attempting to publish papers using racial discrimination inventories, she says she’s noticed skepticism and a double standard.
“There is a different standard that we’re held to,” she says. “Like, ‘How do you know that people really experienced racism? How do you know that these aren’t people who are just more sensitive to slights?'”
While she and Harnett both say they’ve seen improvements in their field, they hope their work will push other institutions toward a better understanding of how racism can change the brain.
“Many times in the medical community, you know, racism hasn’t been recognized as the kind of insidiously damaging stressor that it is,” Fani says. “The hope is that this kind of brain research can lend a kind of legitimacy to racism as a potent social stressor that has a very clear and pronounced effect on the brain.”
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